Medical Debt Resource Roundup

Overview From the Southern Partnership to Reduce Debt

Posted August 3, 2021
By the Annie E. Casey Foundation
A woman holding a sheet of paper, sitting at a desk looking concerned, with a white couch behind her.

Fam­i­lies in the South — like all fam­i­lies — want to live healthy, finan­cial­ly secure lives. Yet many hard-work­ing house­holds in the region are grap­pling with crip­pling debt that under­cuts their eco­nom­ic security.

Med­ical bills play a sig­nif­i­cant role in fuel­ing this instability.

Peo­ple of col­or are espe­cial­ly like­ly to strug­gle with this debt, as they dis­pro­por­tion­ate­ly lack med­ical insur­ance, expe­ri­ence more health prob­lems that require care, and gen­er­al­ly have less wealth and income com­pared to white people.

The coro­n­avirus pan­dem­ic has wors­ened these chal­lenges, accord­ing to recent sur­veys and stud­ies. Many Amer­i­cans — includ­ing indi­vid­u­als who have unex­pect­ed­ly lost their jobs and their asso­ci­at­ed health insur­ance dur­ing this cri­sis — are fac­ing large med­ical bills after con­tract­ing COVID-19.

Issues asso­ci­at­ed with med­ical debt can grow over time. When report­ed to cred­it bureaus, unpaid hos­pi­tal fees can chip away at an individual’s cred­it score and impact every­thing from their employ­ment prospects to home pur­chas­ing power.

Ele­vat­ing Med­ical Debt, Solutions

The Annie E. Casey Foundation’s South­ern Part­ner­ship to Reduce Debt (SPRD) seeks to high­light prob­lems asso­ci­at­ed with debt — includ­ing med­ical debt — and advo­cate for solu­tions on behalf of res­i­dents in sev­er­al South­ern states.

Below is a range of mate­ri­als doc­u­ment­ing prob­lems and poten­tial solu­tions asso­ci­at­ed with med­ical debt across the nation and in three SPRD states.


Can’t Win For Los­ing – How Insti­tu­tions and Poli­cies Keep Arkansans in Debt

By the Arkansas Com­mu­ni­ty Institute

This report sum­ma­rizes results from a sur­vey of more than 1,000 res­i­dents in Arkansas’ Pulas­ki and Jef­fer­son coun­ties. It found that near­ly half of all sur­vey respon­dents had some form of med­ical debt.

The pub­li­ca­tion offers rec­om­men­da­tions for how state pol­i­cy­mak­ers can address prob­lems relat­ed to health-care debt, includ­ing end­ing work require­ments for the state’s Med­ic­aid enrollees and improv­ing the program’s ser­vice deliv­ery. It also calls on hos­pi­tals to edu­cate patients about finan­cial assis­tance pro­grams and to refrain from using debt-col­lec­tion agen­cies for past-due bills. 


Med­ical Debt in Ten­nessee: Who Has It and Why Does It Matter?

By The Sycamore Institute

This report exam­ines med­ical debt as it relates to Ten­nessee res­i­dents. It finds that med­ical debt is com­mon across most demo­graph­ic and socioe­co­nom­ic groups and more com­mon among the unin­sured, those with low­er incomes or edu­ca­tion lev­els, and peo­ple of col­or. It also illus­trates how even small amounts of med­ical debt can hin­der eco­nom­ic secu­ri­ty and mobil­i­ty by feed­ing debt cycles and reduc­ing access to jobs, hous­ing and wealth-build­ing credit. 

Med­ical Debt Case Study: Using Med­ic­aid Cov­er­age to Pre­vent Med­ical Debt

By Ten­nessee Jus­tice Center

This paper out­lines an ini­tia­tive by the Ten­nessee Jus­tice Cen­ter and local hos­pi­tals. It explores the center’s efforts to train and edu­cate hos­pi­tal staff on elim­i­nat­ing bar­ri­ers to long-term Med­ic­aid cov­er­age as a means of pre­vent­ing med­ical debt from amass­ing in the first place. 


The Moun­tain of Med­ical Debt In Texas: Peo­ple of Col­or Are Hit Hard­er in Texas Than Any Oth­er South­ern State

By Every Tex­an

This pub­li­ca­tion details the grow­ing prob­lem of med­ical debt in Texas, espe­cial­ly for Tex­ans of col­or. The paper calls on Texas pol­i­cy­mak­ers to expand access to health insur­ance and estab­lish new pro­tec­tions for low-income patients who can’t afford med­ical care.

Nation­al Reports

Med­ical Debt and its Impacts on Health and Wealth: What Can Phil­an­thropy Do to Help?

By the Aspen Insti­tute Finan­cial Secu­ri­ty Pro­gram and Asset Fun­ders Net­work

This report exam­ines the toll of med­ical debt across the nation and iden­ti­fies it as an issue that dis­pro­por­tion­ate­ly impacts peo­ple of col­or. The doc­u­ment also shares a range of strate­gies that phil­an­thropic insti­tu­tions can sup­port to help address this challenge.

An Ounce of Pre­ven­tion: A Review of Hos­pi­tal Finan­cial Assis­tance Poli­cies in the States

By Nation­al Con­sumer Law Center

This pub­li­ca­tion explores states’ sup­port for hos­pi­tal finan­cial assis­tance plans, which can help facil­i­tate free or high­ly dis­count­ed care for low-income and unin­sured patients.

The report reviews each state’s approach, in terms of finan­cial assis­tance and eli­gi­bil­i­ty require­ments, and takes a clos­er look at sev­en states with strong poli­cies. These states — Cal­i­for­nia, Con­necti­cut, Maine, Neva­da, New Jer­sey, New York and Rhode Island — all man­date that hos­pi­tals offer dis­count­ed or free care to cer­tain patients with low incomes.

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